Business Administration, Management, and Operations Commons^™

The Relationship Between Registered Nurse Burnout, Organizational Engagement, And Quality Outcomes In Acute Care Hospitals, James E. Parsons

Theses, Dissertations and Capstones

Registered Nurse (RN) burnout remains a significant challenge in acute care hospitals, with far-reaching consequences for staff well-being, organizational performance, and patient care outcomes. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout among RNs contributes to decreased job satisfaction, increased turnover, and compromised care quality. Despite extensive research on burnout, few studies have integrated theoretical frameworks such as the Theory of Reasoned Action (TRA) with large-scale, nationally representative data to empirically test how burnout influences organizational engagement and healthcare quality outcomes.

This quantitative, non-experimental study examined relationships among RN burnout, organizational engagement, and patient care …

Imposter Phenomenon And Leadership Effectiveness In Female Leaders: Exploring The Roles Of Intellectual Humility, Perfectionism, And Mentorship, Christina Clarke

Theses, Dissertations and Capstones

First identified by Clance and Imes in 1978, Imposter Phenomenon describes a widespread psychological experience marked by persistent self-doubt, difficulties in accepting personal achievements, and a fear of being exposed as an unqualified "fraud" despite demonstrated competence. For over 45 years, most research on IP has primarily focused on its negative impacts, both personally and professionally, although limited recent studies have highlighted some positive aspects. While IP doesn’t differ amongst groups, most of the research and layman’s content on IP is associated with females. Drawing on empirical data that gender-diverse leadership outperforms homogeneous leadership teams, this research seeks to address …

Management Control Systems And Financial Stability In Nonprofit Organizations, Mary Constance Augustine

Theses, Dissertations and Capstones

Nonprofit organizations are critical to the United States economy, employing more than 12.8 million and providing vital services beyond what government programs can accomplish. These organizations are facing unparalleled financial challenges as competition for revenue sources increases and competitive pressure to excessively reduce overhead costs increases. Over the last three decades, managerial accounting literature has studied the effect of management control systems on innovative abilities in the commercial sector and recently, scholars have begun to apply these theories and methods to the nonprofit sector. Using Simons’ Levers of Control framework, this study employs a validated survey scale for nonprofit organizations …

Burnout And Workforce Outcomes Among Registered Nurses, Madeline Willcoxen

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationship between staffing and organizational support interventions and workforce outcomes among registered nurses providing direct patient care in hospital settings. The study focused on three measurable outcomes: emotional exhaustion, absenteeism, and annual nurse turnover. The population included hospital-based registered nurses, and the comparison involved standard staffing and support conditions.

Methods: A systematic literature review was conducted following PRISMA 2020 guidelines. Studies published between 2015 and 2026 were identified using PubMed, CINAHL, Scopus, and PsycINFO databases. Inclusion criteria required quantitative studies examining staffing or organizational support interventions among registered nurses in …

Ai In The Workplace: Understanding Role Ambiguity, Employee Motivation, And Learning Engagement, Sheena Leah Metzger

Theses, Dissertations and Capstones

The rapid integration of artificial intelligence (AI) into organizational processes has altered how work is performed and experienced by employees, yet empirical research examining the human implications of AI-driven change remains limited. This study examined the perceived impact of AI implementation on role ambiguity, employee motivation, and training engagement, and investigated the moderating role of perceived organizational support (POS). Grounded in Job Demands–Resources (JD-R) Theory and Organizational Support Theory (OST), the research examined how employees interpreted and responded to AI-related changes in their work environment.

The results offer valuable insights into a shifting perception of how employees experience technology in …

Performance Outcomes Of Critical Access Hospitals: A Resource Dependence Theory Evaluation Of Change Of Ownership Versus Independence, Colette Christina Martin

Theses, Dissertations and Capstones

Critical Access Hospitals (CAHs) play a vital role in sustaining healthcare access in rural communities, yet many face persistent financial and operational constraints. A change in hospital ownership is frequently seen as a strategy to sustain these hospitals, improve access to capital, supplement administrative infrastructure, and leverage system-level expertise. However, empirical evidence regarding the effectiveness of acquisition for CAHs remains limited and mixed. Guided by Resource Dependence Theory (RDT) and the Balanced Scorecard framework, this study examines whether ownership change is associated with differences in financial performance, utilization, staffing, and quality outcomes among CAHs.

Using Medicare Cost Reports, the American …

Signals Of Value: A Comparative Analysis Of Sde And Ebitda In Predicting Microbusiness Sale Price, Joseph E. Turley

Theses, Dissertations and Capstones

This dissertation compares the predictive accuracy and stability of Seller’s Discretionary Earnings (SDE) and Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) in explaining realized sale prices of microbusinesses. Microbusinesses, defined as firms with fewer than ten employees and annual revenue below $2.5 million, face persistent valuation challenges due to information asymmetry, owner dependence, and informal financial reporting. The study analyzes 5,499 completed U.S. transactions from the DealStats database (2014–2024) after applying microbusiness criteria and outlier trimming. Predictive accuracy is measured by absolute percentage error between actual sale prices and prices implied by each metric. Findings show that SDE-based predictions …

Tele-Psychiatry Adoption And Its Effect On Rural Mental Health Service Availability, Anna Heineman, Kaylee Canterbury, Taylor Carpenter

Theses, Dissertations and Capstones

Purpose of study: This study examined the association between tele-psychiatry implementation and mental health service availability in rural healthcare settings. The analysis compared tele-psychiatry to traditional in-person psychiatric care among rural populations, focusing on access and utilization outcomes, including time to first psychiatric appointment, number of completed visits, and appointment no-show rates.

Methods: A qualitative literature review following a systematic approach was conducted using peer-reviewed articles published between 2016-2026. Databases included PubMed, ProQuest Health, CINAHL, Journal of Medical Internet Research, and the National Library of Medicine, with Google Scholar used as a supplemental source. The review followed PRISMA …

Artificial Intelligence–Enabled Revenue Cycle Management And Financial Performance In Healthcare Organizations, K’Reesa Webster

Theses, Dissertations and Capstones

The purpose of this review was to examine how artificial intelligence–enabled revenue cycle management (AI-enabled RCM) systems have been associated with financial performance outcomes in healthcare organizations. A literature review following a systematic process consistent with PRISMA 2020 guidelines was conducted to identify quantitative studies published between 2015 and 2026. Eligible studies were required to report at least one financial outcome related to claim denial rate, days in accounts receivable, or operating margin. Twenty-seven studies met all inclusion criteria. Findings across these studies indicated that AI-enabled RCM systems have been associated with lower denial rates, shorter accounts receivable timelines, and …

Psilocybin-Assisted Therapy And Alcohol Use Disorder, Zoe R. Evans

Theses, Dissertations and Capstones

This current paper has studied whether the psilocybin-assisted treatment has been linked with meaningful shifts in three clinical outcomes among adults 18 years old and above diagnosed with alcohol use disorder (AUD): percentage of heavy drinking days, abstinence rates, and neural responsiveness to alcohol-related cues. A literature review following a systematic approach was performed using guidelines from PRISMA 2020 based on four databases, namely PubMed and PsycINFO, and Scopus and CINAHL, where peer-reviewed articles published between 2015 and 2026 were included. A semi-structured professional interview with a clinical researcher in the Division of Addiction Sciences of Marshall University was also …

The Successful Transition To Executive Leadership Roles In The Pharmaceutical Industry, Eddie J. Fuller

Theses, Dissertations and Capstones

The underrepresentation of minority groups in leadership roles within the pharmaceutical industry constitutes a significant issue, as evidenced by various studies. These studies consistently indicate that individuals from underrepresented groups are less likely to progress into leadership positions. It appears that much of the existing literature discusses African American women as the identified underrepresented group. This dissertation investigates the underrepresentation of minority groups in leadership roles within the pharmaceutical industry. The sample comprises both minority and majority participants who currently hold or have previously held leadership positions in pharmaceutical companies within the United States. This dissertation uses survey questionnaires to …

Navigating Loyalty: Exploring Perceptions In Family-Owned Businesses, Elisabeth Ann Arthur

Theses, Dissertations and Capstones

Family businesses are crucial to the global economy, contributing significantly to the Gross Domestic Product (GDP) and employing a diverse workforce. Like any other business, familyowned businesses are not immune to employee turnover. Employee perception of business stability is a key indicator of the business's health and resilience. This study aims to examine the relationship between employee perceptions of family business stability, business community involvement and turnover intentions using a quantitative survey. The survey was developed using validated scales and received approval (IRB #2206773) from the Institutional Review Board (IRB) at Marshall University prior to administering to family business employees …

Convenience And Price: What Leads To Repurchase Intent?, Brittany Thierman

Theses, Dissertations and Capstones

This study strives to understand drivers of repurchase intent for service-based small businesses in terms of firm attributes and service conveniences. This study also examines the impact of customer satisfaction on repurchase intent in service-based small businesses. The theories used for this research are Economic Utility Theory and the Theory of Planned Behavior. This research aims to identify which factors are most important when starting the customer journey with a service-based small business, including signing up for the service, realizing the benefit, and the customer’s intention to repurchase. This research will compare firm attributes, including price discounts and service conveniences. …

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …

Big Data Analytics In Inventory Management In Healthcare Supply Chain, Bailee White

Theses, Dissertations and Capstones

Introduction: As healthcare organizations increasingly have relied on digital transformation to meet growing demands for efficiency and cost reduction, big data analytics have emerged as a key tool for optimizing supply chain performance. Inventory management, which accounted for up to 50% of total hospital operating costs, remained one of the most critical and complex areas in the healthcare supply chain. Traditional inventory methods often led to stockouts, waste, and inefficiencies. The integration of big data tools such as predictive analytics and enterprise resource planning systems presented an opportunity to streamline operations and reduce costs.

Purpose of the Study: …

Evaluating The Effectiveness Of Teledermatology For Undeserved Populations During And Post-Covid-19, Jakob Gibbs, Sean Hanshaw

Theses, Dissertations and Capstones

Introduction: Teledermatology, a subset of telemedicine, has gained prominence as a means to increase access to dermatologic care while reducing costs and improving patient satisfaction. The swift expansion of teledermatology during the COVID-19 pandemic was driven by the necessity to limit physical contact and adapt to public health restrictions. This technological shift aimed to address longstanding disparities in dermatology access, especially in rural and underserved populations, and to respond to the rising demand for dermatologic services amid provider shortages.

Purpose of the Study: The purpose of this study was to analyze the effects that teledermatology following the COVID-19 pandemic had …

The Impacts Of Artificial Intelligence In Radiology, Misty Farmer, Wendy Trzyna

Theses, Dissertations and Capstones

Introduction: There has been significant growth in the use of Artificial Intelligence (AI) in the healthcare industry, especially in Medical Imaging. Radiology has been the clear frontrunner in the adoption of AI in medicine, due in part to the massive amount of digital data available for use in Deep Learning (DL) AI integration has the potential to solve multiple challenges in radiology, address workload issues and transform the field.

Purpose of the Study: The purpose of the research was to evaluate the impact of implementing Artificial Intelligence in radiology to determine if these technologies have had an impact …

Addressing The Opioid Epidemic Across The United States And In West Virginia, Kailyn Smith, Addison Hughes

Theses, Dissertations and Capstones

Introduction: The opioid crisis had a profound impact on public health across the United States and West Virginia, with overdose deaths reaching unprecedented levels by 2021. Traditional abstinence-only rehabilitation programs demonstrated limited success, largely due to high relapse rates and insufficient mental health support. These programs often overlooked the complex relationship between opioid addiction and co-occurring mental health disorders such as depression and anxiety, which are common among those with substance use disorders. In contrast, Medication-Assisted Treatment (MAT), when supplemented with behavioral therapies and antidepressant medications, has shown greater success in improving recovery outcomes and reducing relapse rates. This …

Safety Ratings And Their Effect On Operating Costs In The Trucking Industry: A Data-Driven Analysis, Teresa L. Smith

Theses, Dissertations and Capstones

This dissertation explored the interplay between safety ratings and financial performance within the transportation sector, with a specific focus on the trucking industry. In an era where safety standards are paramount, the primary objective of the study was to determine the impact of safety ratings on the operating costs of trucking firms. Using a robust methodology grounded in quantitative analysis and industry-specific secondary data, the study established empirical connections between safety ratings and operating costs. This included a focused effort to identify direct effects, highlighting the potential influence of lower safety ratings on economic outcomes within the trucking industry.

Furthermore, …

Assessing The Impact Of Financial, Educational, And Managerial Resources On The Success Of Minority-Owned Businesses: An Analysis Of Resources From The Perspective Of The Minority Business Owner, Clinton B. Arnold

Theses, Dissertations and Capstones

Minority-owned businesses (MOBs) in the United States have a failure rate that is 50% higher than that of their non-minority counterparts. Rectifying this imbalance and achieving parity could yield significant economic benefits, potentially adding $1.5 trillion to the nation's economy if resources—financial, educational, and managerial—are equitably distributed and effectively made available to support the goals of minority businesses. However, historical injustices, from Jim Crow laws to systemic discrimination, have granted certain groups multi-generational advantages, exacerbating the divide. Addressing these disparities is both an economic imperative and a moral obligation to ensure equal opportunity. Lending Tree (2023)

With 1.2 million MOBs …

Beyond The Screen: Assessing The Impact Of Hospitalist Reliance On Electronic Medical Records In Patient-Centered Care, Brian H. Cox

Theses, Dissertations and Capstones

The integration of Electronic Medical Record (EMR) systems has transformed healthcare delivery, offering enhanced data accessibility, improved communication, and operational efficiency. However, concerns persist regarding the potential erosion of patient-centered care due to EMR overutilization. This study investigated how hospitalists’ use of EMR systems correlates with patient satisfaction, focusing on the dynamics of physician communication, hospital length of stay, and regional characteristics. Using a comprehensive framework combining Resource Dependency Theory and Donabedian’s Structure-Process-Outcome model, the research examines the influence of demographic, technological, and structural factors on healthcare outcomes.

The analysis, based on patient survey data from a large integrated delivery …

Systemic Challenges In Pediatric Healthcare: Exploring Reimbursement Disparities And Their Impact On Healthcare Equity, Jessica Ford-Davis, Alexandra Gillette

Theses, Dissertations and Capstones

Introduction: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) have provided health coverage for over 135 million Americans, with Medicaid playing a significant role in financing pediatric healthcare. Medicaid covers a wide range of services for children, particularly those from low-income families or with special healthcare needs, including preventive care, immunizations, vision and dental services, and mental health treatments. However, Medicaid reimbursement rates are lower compared to Medicare and private insurance, in some cases 30.6% lower, and have often been insufficient to cover the full cost of care, contributing to financial losses for children's hospitals. Despite these challenges, nearly …

Magnet Hospitals And Their Impact On Patient Outcomes, Connie Cochran, Molly A. Collins

Theses, Dissertations and Capstones

Introduction: In the competitive healthcare landscape, patient safety and quality care have remained critical priorities. The Magnet Recognition Program, awarded by the American Nurses Credentialing Center (ANCC), has recognized hospitals that have demonstrated excellence in nursing and improved patient outcomes. Built on five core pillars: transformational leadership, structural empowerment, exemplary practice, innovation, and quality results, this designation has supported professional development and collaborative care. Although only about 10% of U.S. hospitals have been Magnet-designated, they have been linked to reduced hospital mortality, hospital-acquired infections (HAIs), and patient falls.

Purpose of the Study: The purpose of this research was to evaluate …

Employee Benefit Plan Audits: Knowledge Spillover For Improving Quality, Lisa Ann Nash

Theses, Dissertations and Capstones

This study provides a unique glimpse into the work of non-BigN accounting firms offering Employee Benefit Plan (EBP) audit services for single employer defined contribution plans. The study examines knowledge spillover from joint services and EBP auditor specialization to improve EBP audit quality. EBPs often incur low-quality audits, resulting in penalties assessed by the Department of Labor (DOL) for deficiencies. Companies may feel a sense of comfort hiring the same auditor they used for their company financial statements, but the EBP audits require the auditor to possess specialized knowledge beyond the requirements for the financial statements to confirm compliance with …

Factors That Impact Customer Loyalty As Examined In Integrated Marketing Communications Agencies, Terry L. Hapney Jr.

Theses, Dissertations and Capstones

Integrated Marketing Communications (IMC) agencies report high customer turnover, making it difficult for them to retain customers in the B2B realm. Relationship Marketing Theory informs this study, which centers on IMC firm growth from market share. Market share is a result of customer loyalty. There are factors that IMC agency leaders, such as CEOs and CMOs, can leverage to strengthen customer loyalty, including satisfaction, trust, quality, value, habit, engagement, attachment, image, and reputation. This study examines these concepts collectively for the first time in any context; it also examines them specifically in the IMC agency context for the first time. …

Uncovering New Perspectives On Job Performance In Diverse Work Settings: A Job Demand-Resource Theoretical Approach, Myesha P. Holmes

Theses, Dissertations and Capstones

The aim of this study was to integrate the agility literature within the theoretical framework of the Job Demand-Resource (JD-R) Theory to examine and validate whether employee agility (job resources) and work overload (job demands) influence the relationship between subjective wellbeing, work engagement, and job performance among remote, hybrid, and onsite workers. Data was collected through a Qualtrics Online panel, utilizing five standardized and validated scales, from a sample of 504 full-time employed respondents across the United States. The data was analyzed using Structural Equation Modeling (SEM) and Analysis of Variance (ANOVA). The results indicated a significant relationship between employee …

The Influence Of Generative Artificial Intelligence On Leadership: An Exploration Of Technology Professionals' Perceptions Regarding Leadership, Adaptation, And Organizational Culture In The Digital Age, Paul Thomas Herdman

Theses, Dissertations and Capstones

The emergence of generative artificial intelligence (GenAI) has introduced new complexities for organizational leadership, requiring technology professionals to adapt in real time to evolving digital tools, strategic demands, and cultural dynamics. Although prior research has examined AI’s broad influence on business processes, few studies have explored how technology leaders experience and interpret the leadership challenges and opportunities arising from GenAI. This qualitative dissertation addressed that gap by investigating the perceptions of senior technology professionals regarding GenAI’s influence on leadership roles, competencies, decision making, and organizational culture. Using Lanigan’s (1977) phenomenological method of human science, this study explored the lived experiences …

Investing In Leaders To Support Neurodiversity At Work, Beth M. Houran

Theses, Dissertations and Capstones

Neurodiversity-focused hiring initiatives, such as those pioneered by JP Morgan Chase, DXC Technology, and Microsoft, are addressing talent shortages by harnessing the unique strengths of neurodiverse individuals. This research investigated the role of emotional intelligence, servant leadership, and organizational resources in supporting neurodiverse teams. Grounded in the conservation of resources theory, the findings reveal that EI is a significant antecedent to SL, enabling leaders to foster stronger relationships and engage in extra-role behaviors with neurodiverse employees. Notably, while SL positively impacts leader-member exchange and organizational citizenship behavior toward individuals, the hypothesized moderating role of resources was not supported, suggesting that …

Do Patients Who Receive Dexmedetomidine As An Adjunct To Spinal Anesthesia For Cesarean Delivery Achieve Longer Block Duration Compared To Those Who Receive Spinal Anesthesia With Local Anesthetic Alone?, Liana S. Garrison

Theses, Dissertations and Capstones

Problem Statement: Cesarean delivery is associated with significant postoperative pain, typically managed with spinal anesthesia using a local anesthetic. While opioids are often added as adjuncts, the addition of dexmedetomidine, an alpha-2 agonist, has emerged as a potential alternative that may enhance the efficacy of the spinal block in terms of pain management, potentially improving block duration and quality compared to local anesthetic alone.

Methodology: A literature review was conducted on the use of dexmedetomidine as an adjunct to spinal anesthesia for patients undergoing cesarean sections. Databases used for the search included PubMed, CINAHL Complete, and MEDLINE. The keywords used …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …