Medicine and Health Sciences Commons^™

High Health Care Cost In The U.S. And Its Impact On An African American Church Community In East Orange, New Jersey, William Charles

Doctoral Dissertations and Projects

Access to affordable quality health care has been a long debating issue in the United States. Many scholarly research articles indicated that the cost of insurance premiums, deductibles, co-payments, and prescription drugs continue to rise every year. Despite various efforts to reduce the cost of health care in the United States, the trend remains the same. Au contraire, more Americans are unable to afford the cost of prescription drugs. More Americans postpone their medical treatments. More Americans find it difficult to financially address their health care needs. It can be inferred that high health cost has a significant impact in …

Teamstepps And Organizational Culture, Amelia Arca Quinto

Doctoral Dissertations and Projects

Patient safety issues remain despite several strategies developed for their deterrence. While many safety initiatives bring about improvement, they are repeatedly unsustainable and short-lived. The index hospital’s goal was to build an organizational culture within a groundwork that improves teamwork and continuing healthcare team engagement. Teamwork influences the efficiency of patient care, patient safety, and clinical outcomes, as it has been identified as an approach for enhancing collaboration, decreasing medical errors, and building a culture of safety in healthcare. The facility implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for …

Certified Nursing Assistant Turnover In The Long-Term Care Facility Industry, Michael Leroy Gregory

Doctoral Dissertations and Projects

Employee turnover in long-term care facilities results in increased operational costs and a reduction in the quality of care delivered. The purpose of this correlational study was to investigate the relationships between employee turnover intention of certified nursing assistants working in long-term care facilities and employee compensation, engagement, job satisfaction, motivation, perceived work stress during the COVID-19 pandemic, and work environment. The population of interest consisted of CNAs over the age of 17, with at least two years of experience working in the central Texas long-term care industry. Herzberg’s motivation-hygiene theory served as the theoretical framework underpinning this study. Multiple …

Communicating The Value Contributions Of Pathology And Laboratory Medicine (Palm) To Healthcare Administrators, Evidence Of Value From A Multiple Cases Study, Susan K. Edralin

Doctoral Dissertations and Projects

Hospital administrators were interviewed to explore their perceptions of the strategic alignment of PaLM value-based activities (VBAs). Hospital based PaLM leaders were interviewed to explore their communication of the VBAs. This study identified a misalignment between the assessments utilized by healthcare administrators for PaLM services and the value contributions of laboratorians. PaLM leaders offered insight into the laboratory’s value chain. Three themes emerged from the data: PaLM VBAs, PaLM communication efforts, and PaLM VBA strategic alignment. Together these findings suggest that hospital laboratorians offer untapped value in healthcare, and hospital administrators failing to recognize this value miss opportunities to improve …

The Ems Deficit: A Study On The Excessive Staffing Shortages Of Paramedics And Its Impact On Ems Performance In The States Of South Carolina And North Carolina And Interventions For Organizational Improvements., James Boyd Eubanks

Doctoral Dissertations and Projects

This is a qualitative multi-case study on emergency medical services (EMS) paramedic shortages, their effects on ambulance responses, and the quality of patient care in the prehospital environment. A qualitative multi-case study was selected for this study because the nature of the methods’ design aligned with a systematic approach of life experiences (Creswell, 2015). Paramedics who participated in this study provided insight, from life experiences, as to why one prematurely leaves EMS; thus, creating a staffing shortage. The foundation of this study is the high staffing shortages of paramedics specifically in South Carolina (SC) and North Carolina (NC). Drastically reducing …

Analyzing The Investment Potential To Increase Prenatal Care Utilization As A Tactic To Decrease Preterm Birth Costs In Tennessee, Michael S. Wiggins

Doctoral Dissertations and Projects

Preterm birth contributes significantly to health care costs in the United States (Frey & Klebanoff, 2016). Certain components of prenatal care reduce preterm birth incidence (Newnham et al., 2014). Tennessee’s preterm birth rate ranks 35th among the 50 United States (National Center for Health Statistics, 2019). This study analyzed the investment potential to reduce preterm birth cost through increasing prenatal care utilization in Tennessee. Based on 2018 data, the study identified a significant relationship between prenatal care utilization and preterm birth incidence in Tennessee. The study also identified a significant opportunity to increase prenatal care utilization in Tennessee when compared …

Connecting Healthcare – Leveraging Technology To Promote Value-Based Care In The Emergency Department, Ahnna Michelle Jackson

Doctoral Dissertations and Projects

The emergency department is a fast-paced and complex environment that serves hundreds of thousands of people a day across the state of Georgia. The establishment of a culture of value-based care in the emergency department is attainable but often falls short when the staff cannot properly leverage the technology available to them. Framed by the Complex Adaptive Theory and The Input/Throughput/Output Model of ED Patient Flow, the purpose of this qualitative case study was to explore how emergency department leaders and staff could better leverage technology to develop and sustain a culture of value-based care. The 30 participants in this …

Perceptions Of Health Insurers Towards Pay-For-Performance As A Cost Control Model For Hospital Services, Mandlenkosi Moyo

Doctoral Dissertations and Projects

Hospital costs are the most significant portion of health-related costs incurred by non-profit health insurers registered as medical schemes in South Africa. Medical schemes continue to use retrospective reimbursement models for hospitals despite general acknowledgment that these models do not limit hospital costs and utilization. Although medical schemes are interested in implementing alternative reimbursement models, such as pay-for-performance (P4P), they are uncertain about which P4P models they can use to reduce hospital costs, resulting in their inability to make critical changes to their costs from traditional fee-for-service models. This qualitative exploratory multiple case study used 17 open-ended case interviews to …

Employee Wellness Program Participation: Exploring Participation Of Registered Nurses In East Tennessee, Jacquelyn Turner

Doctoral Dissertations and Projects

Many organizations are faced with the challenge of managing employee retention and absenteeism. While retention strategies are focal to organizational leaders across the board, the growing shortage of nurses nationwide creates a critical concern for healthcare leaders. The purpose of this qualitative case study was to delve into the existing body of research pertaining to the impact of employee wellness programs on employee retention and absenteeism and further explore the reasons why employees choose to/ not to participate in wellness programs offered by employers. The intent of this study was to add to the existing body of knowledge on employee …

High Reliability In Medication Administration, Bradford White Jensen

Doctoral Dissertations and Projects

This research was designed to test the theory of Robust Process Improvement (RPI) as it has been applied to the problem of medication error at Navy medical treatment facilities (MTFs). Medication error is the greatest cause of patient injury in America. In an effort to duplicate the success of High Reliability Organizations (HROs), leaders of the Joint Commission advocated the application of Lean Six Sigma (LSS) as the key elements of RPI and the best way to increase safety and improve the quality of healthcare. The specific problem was that very little empirical evidence existed supporting the theory. The research …

Therapeutic Delivery Technology And Its Economic Impact, Paul E. Savas Jr.

Senior Honors Theses

Therapeutic delivery technology is a current area of high interest in both university and industrial settings. These technologies are being developed in order to deliver therapeutic agents, such as genes, proteins, and drugs, to patients more efficiently. Nanoscale delivery vehicles have proven to be useful for these applications; these vehicles may either be naturally produced or chemically synthesized. The physical properties of these nanomaterials must be characterized correctly using instrumentation that evaluates their size, morphology, and potential for agglomeration. These technologies represent a high-growth economic area that fosters entrepreneurship and innovation. Because of this innovative spirit, research and economic interest …

Selling Life To Abortion-Seekers: A Content Analysis Of Passive And Active Persuasion In Crisis Pregnancy Center Marketing, Alexander Kocman

Masters Theses

For supporters of the pro-life cause, crisis pregnancy centers (or CPC's) have become the "darlings of the movement," according to the New York Times (Belluck, 2013), offering women with unplanned pregnancies free advice, information, classes, childcare, and needed supplies. For abortion advocates, such establishments are intended to seduce vulnerable abortion-seekers into a situation where they will be counseled out of an abortion and possibly even proselytized. Yet for as much controversy as exists in the news media, medical community, and legal realm about CPC's, there is an unsettling lack of understanding of how--and why--CPC's market themselves the way they do. …

An International Cross-Cultural Study Of The Role Of Chief Informational Officers In Healthcare, Wallace Saunders

Faculty Dissertations

The introduction and utilization of Information Systems (IS) in the hospital environment has had a significant and lasting impact on the practice of medicine. The development of this dissertation will attempt to explore a widely overlooked area: The comparison of Chief Information Officers (CIOs) in the United States and the United Kingdom.

Aspects of CIO experiences relating to assumed roles, CIO challenges, skills, frustrations, success, failure, leadership, management, involvement and perceptions about the role of Information Technology (IT) in healthcare are discussed with a comparative global model. This study investigates the managerial roles of the Chief Information Officer based on …