Medicine and Health Sciences Commons^™

Strategies Small Construction Business Managers Use To Reduce Safety Incidents In Their Organization, Peggy Ann Mcknight

Walden Dissertations and Doctoral Studies

Globally the construction industry struggles to prevent injurious and fatal safety incidents. The purpose of this single case study was to explore strategies used by construction business managers that had significantly reduced the occurance of safety incidents in a Northwest Ohio construction company. Data were collected from organizational records and interviews with 6 construction managers. The conceptual framework for this research was the concept of safety management systems. Data were compiled and organized, disassembled into fragments, grouped, and then interpreted for meaning. Methodological triangulation and member checking were used to enhance reliability and validity. Four themes emerged from the data: …

Workplace Bullying From A Nurses Perspective, Dawn Reid White

Walden Dissertations and Doctoral Studies

Bullying has long been associated with school children. In recent years, however, more attention has been paid to the bullying that has reached beyond the playground and into the workforce. One population facing this problem is staff nurses. To date, no one has found an effective way to address workplace bullying in the healthcare field, nor have effective methods been found for retaining trained nurses affected by this problem. The focus of this dissertation was on understanding nurses' lived experiences and how nurses decided to remain in their current working position despite these problems. Taking a phenomenological approach and using …

Quality Of Life Among Entrepreneurs With Chronic Fatigue Syndrome, Brittany Kesler

Walden Dissertations and Doctoral Studies

The impacts of chronic fatigue syndrome (CFS) are far reaching, resulting in many burdens in the individual lives of CFS patients. One notable challenge lies in the inability to participate in the workforce due to associated physical, mental, and emotional symptoms. Previous research indicates that alternative employment options may help to overcome work related barriers presented with various types of chronic illness. Entrepreneurship is one path to working that offers many benefits, including autonomy, flexibility of work schedule, choice of work environment, and control. Questions though remain as to whether entrepreneurship enhances QOL or exacerbates symptoms among individuals with CFS. …

Strategies For Healthcare Payer Information Technology Integration After Mergers And Acquisitions, Kishore Maranganti

Walden Dissertations and Doctoral Studies

Despite the high rate of failure in merger and acquisition (M&A) transactions, many organizations continue to rely on M&As as their primary growth strategy and to address market competition. The purpose of this qualitative single case study was to explore strategies managers from a large healthcare payer in the midwestern United States used to achieve operational and strategic synergies during the postacquisition information technology (IT) integration phase. Haspeslagh and Jemison's acquisition integration approaches model was the conceptual framework for the study. Methodological triangulation was established by analyzing the data from the semistructured interviews of 6 senior executives and 6 IT …

Chaplaincy Inclusion In Hospital Interdisciplinary Teams And Its Impact On Chaplains' Well-Being, Chike Nzegwu

Walden Dissertations and Doctoral Studies

Healthcare providers may impede the delivery of spiritual and emotional support to

patients and their families by healthcare professional chaplains if they misunderstand how to effectively use chaplains, who often prefer to be engaged sooner than they are. This issue prevents highly trained, board-certified professional chaplains from providing services, thereby impacting the quality of patient care. The purpose of this phenomenological study was to examine, through the lived experiences of professional chaplains, the extent to which chaplains feel that others perceive them as valued members of an interdisciplinary team (IDT), as well as to determine how team inclusion may impact …

Stress Reduction Strategies For Improving Private Security Officer Performance, Khalil Ibrahim Al-Mulla

Walden Dissertations and Doctoral Studies

The impact of occupational stress on employees' health and work performance costs U.S. companies $300 billion annually; work-related stress is an issue for private security organizations all over the world. The purpose of this single case study was to explore strategies private security organizational leaders used to mitigate private security officers' occupational stress. The study participants were 4 leaders of a private security organization in Bahrain who had a minimum of 5 years of experience in the private security field and had addressed occupational stress successfully. The human capital theory was the conceptual framework used for this study. Data were …

Influence Of Psychological Capital And Thinking Perspectives On Construction Safety Climate And Performance, Anne-Perrine Pascale Cades

Walden Dissertations and Doctoral Studies

Understanding safety factors in construction is critical to reducing accident frequency and severity. Grounded in the safety performance model, this study was conducted to examine the impact of psychological capital (PsyCap), which consists of the shared variance of hope, efficacy, resilience and optimism, and Past, Present, and Future thinking perspectives, on safety climate and performance. A nonexperimental quantitative design was used to determine whether PsyCap and thinking perspectives of construction project employees predicted safety performance and/or moderated the relationship between safety climate and performance across construction sites in different countries. 411 construction employees were recruited via a multistage and clustering …

Nurse Supervisors And Certified Nursing Assistants: Leadership Characteristics And Job Satisfaction, Jennifer Patterson

Walden Dissertations and Doctoral Studies

Significant costs are associated with the turnover rate of certified nursing assistants (CNAs) in skilled nursing facilities (SNFs), and turnover impacts the quality of care for residents of the SNFs through disruption of care. The purpose of this quantitative cross-sectional study was to identify the leadership characteristics of supervisors most associated with the job satisfaction (JS) of CNAs in SNFs. Herzberg's dual factor theory was used as the theoretical framework to explain the relationship between the leadership characteristics and the associated JS. The research question was used to examine the independent variables of trust, teamwork, supportive supervision, leader-follower relationships, and …

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …

Direct Supervisor Influence On Nurse Engagement, Kelly Elaine Tapp

Walden Dissertations and Doctoral Studies

Nurse engagement is essential for organizational success. If organizations can engage nurses, they may be able to improve organization and patient outcomes. The purpose of the evidence-based practice project was to use current evidence of direct supervisor influence on nurse engagement to create an educational program for clinical leads to use in their interactions with direct reports. The relationship-based care model was used as a framework for the project, and concepts included work engagement, nurse engagement, recognition versus meaningful recognition, professional development, communication, transformational leadership, and authentic leadership. Before and after attending the education program, clinical leads were given a …

Strategies For Compliance With Government Regulations In A Pharmaceutical Company, Charles Jagun

Walden Dissertations and Doctoral Studies

Pharmaceutical companies accrued fines of over $30 billion within 25 years because of noncompliance with regulations. Noncompliance with regulations results in fines and an adverse impact on company profitability. Some pharmaceutical company managers lack effective strategies to ensure overall company compliance with regulation. Based on complexity leadership theory, the purpose of this single case study was to explore strategies pharmaceutical company managers used to ensure compliance with regulatory requirements in Nigeria. The target population was functional managers purposely selected because they had successfully implemented strategies for compliance with the regulatory requirements in Nigeria. Data were collected through face-to-face and telephone …

The Effects Of Cultural Dissimilarity On Employee Job Attitudes And Productivity, Sherrice Olithia Lyons

Walden Dissertations and Doctoral Studies

Organizations in Jamaica have been impacted by globalization and the opportunities and challenges of cultural incompatibilities. Most previous studies on cultural incompatibilities have focused on the impact on expatriates leaving a gap in the literature with respect to the implications for host country nationals, and specifically Jamaicans. This quantitative study focused on employees of 2 companies in Jamaica, an energy company and a hospitality company. It examined cultural dissimilarity with respect to host country nationals and expatriates, and its effect on the productivity, job satisfaction, affective commitment, and normative commitment of these employees (N = 110). In addition to the …

Accountable Care Organization Success Strategies: The Importance Of System Changes, Shelly Pierce

Walden Dissertations and Doctoral Studies

Accountable care organizations (ACOs) are a new health care reform initiative that has been highlighted as one of the most important organizational structures that could lead to quality improvements and cost savings in the United States through shared savings. The inability of health care managers to successfully implement ACOs could result in financial losses, reduced patient access to health care, and poor patient outcomes. Grounded by von Bertanlaffy's general systems theory, the purpose of this multiple case study was to explore the system change strategies health care managers used to implement an ACO to meet ACO quality and cost standards. …

Examining Trauma Exposure, Organizational Climate, And Job Outcomes In Child Welfare, Shano Rodgers

Walden Dissertations and Doctoral Studies

Exposure to traumatic situations is routine for child welfare workers in California, and the attrition rate for newly hired social workers in some states is estimated to be nearly 50% in the 1st year of employment. Prior research has indicated that reasons for dissatisfaction included dysfunctional organizational climate and culture. The purpose of this study was to examine the extent to which trauma exposure contributed to secondary traumatic stress and intent to quit and to examine the degree to which organizational climate moderated the exposure among direct service child welfare employees. Kurt Lewin's field theory, Figley's theory of secondary traumatic …

Community Public-Private Partnership Leadership Synergy In Tanzania, Hawa Yatera Mshana

Walden Dissertations and Doctoral Studies

Although the public-private partnership (PPP) concept in health and social health has been politically accepted as the best pathway to improving health outcomes in many developing nations, implementation lacks leadership synergy. Lack of awareness and engagement of community leaders about PPP interventions and their benefits affect accountability and ownership of health and social care interventions. The purpose of this study was to better understand factors that could promote partnership leadership synergy to enhance ownership and accountability for community health and social welfare initiatives in Tanzania. A qualitative empirical case study design was used; diffusion of innovation and the public-private integrated …

Exploring Management Practices Of The Health Care System For Contractors, Gary L. Williams

Walden Dissertations and Doctoral Studies

Researchers have found that military members serving in war experienced changes in physical and mental health. Military members' healthcare is managed by the Department of Defense. The problem was that management practices of the system for providing long-term healthcare for employees of a contracting company working in foreign combat zones is either minimal or nonexistent. The purpose of this case study was to explore ways that contractor managers and government managers can work together to provide healthcare for those contract employees who will be deployed with the U.S. military. The primary research question was to determine what managers of contractors …

Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua

Walden Dissertations and Doctoral Studies

In comparison to the European healthcare system, the U.S. healthcare system has lower quality care, higher costs, and covers a smaller percentage of the population. Despite the high costs, the U.S. healthcare system remains dysfunctional. The purpose of this exploratory single case study was to identify the strategies that some healthcare managers in a hospital setting in the midwestern region of the United States use to improve efficiency while decreasing healthcare costs. Complex adaptive systems theory was used to frame this study that included face-to-face interviews with 6 highly experienced healthcare managers. Data were collected from audio recorded interviews and …

Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu

Walden Dissertations and Doctoral Studies

The American Recovery and Reinvestment Act (ARRA) of 2009 authorized the distribution of about $30 billion incentive funds to accelerate electronic health record (EHR) applications to improve the quality of care, safety, privacy, care coordination, and patients' involvement in healthcare. EHR use has the potential of saving $731 in costs for hospitals per patient admission; however, most hospitals are not applying EHR to reach the level at which cost savings are possible. The purpose of this single case study was to explore strategies that IT leaders in hospitals can use to apply EHR to achieve the cost saving benefits. The …

Strategies For Developing And Implementing Information Technology Systems For Ehrs, Priscilla Riddley

Walden Dissertations and Doctoral Studies

Some hospital leaders lack the technical expertise to implement electronic health records (EHRs) even though the healthcare industry has a government mandate. The purpose of this single case study was to explore strategies healthcare executives use to develop and implement information technology systems for processing EHRs. The target population consisted of healthcare leaders and managers successful in implementing EHR systems in a healthcare organization. Lewin's 3-step change theory was used as the conceptual framework for this study with data collected from observations (5), semistructured interviews (5), and organizational documents. Descriptive coding was used to identify 3 themes that emerged from …

Management Of Inappropriate Behaviors By Healthcare Risk Managers, Sahar Ebrahim Zadeh

Walden Dissertations and Doctoral Studies

Medical errors are the 3rd leading cause of death in the U.S.. The problem is timely recognition and management of inappropriate healthcare worker behaviors that lead to intimidation and loss of staff focus, eventually leading to errors. The purpose of this qualitative modified Delphi study was to seek consensus among a panel of experts in hospital risk management practices on the practical methods for early detection of inappropriate behaviors among hospital staff, which may be used by hospital managers to considerably mitigate the risk of medical mishaps. High reliability theory guided the research process, utilizing the conceptual framework of fair …

Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton

Walden Dissertations and Doctoral Studies

The problem addressed in this study was how staff working in a residential agency for individuals with an intellectual disability (IID) make decisions about how to implement a healthy diet. The purpose of this study was to identify the influences on decisions made by staff on the meals they provided to their clients with an IID. The theory of planned was used to study the influences of attitude, subjective norms, and perceived behavior control on the meals provided for IID. The key research question explored how staff members make decisions. A qualitative case study design was used. The 12 participants …

Strategies Department Store Managers Use To Increase Employee Engagement, Samara Desir

Walden Dissertations and Doctoral Studies

Business leaders are challenged with sustaining an engaged workforce to achieve economic prosperity in their organizations. The implementation of effective strategies to increase employee engagement can mitigate the challenges of employee disengagement. The purpose of this qualitative, single case study was to explore the strategies that department store managers used to increase employee engagement. The conceptual frameworks selected for the research were Vroom's expectancy theory of motivation and Kahn's engagement theory. The research participants consisted of 5 department store managers, from the northeastern United States, who successfully used strategies to increase employee engagement. Data were collected from the participants in …

Relationship Between Employee Wages, Number Of Employee Referrals, And Employee Turnover Intention, Robert Brown

Walden Dissertations and Doctoral Studies

Employee turnover is a significant contributor to the overall loss of hundreds of billions of dollars in profitability for many business organizations in the United States and abroad combined. Grounded in Maslow's theory of human motivation, the purpose of this correlational study was to examine the relationship between employee wages, number of employee referrals, and employee turnover intentions. The population was composed of employees working in the Southeastern region of the United States. A convenience sample of 92 participants answered questions regarding their wages, number of employee referrals, and completed the Turnover Intention Scale. Results of the multiple regression analysis …

Small Business Marketing Strategies For Physical Therapy Practice Owners, Matthew Lane Daugherty

Walden Dissertations and Doctoral Studies

The United States economy depends on small businesses, which represent 99% of all businesses in the United States, yet approximately 50% of small businesses cease operations in the first 5 years. The purpose of this multiple case study was to explore the marketing strategies used by owners of small businesses to develop and maintain their organization through the initial 5 years of business operation. The population included 5 physical therapy business owners in northeastern Florida who had sustained their business for a minimum of 5 years. The conceptual framework for this study was the brand equity model, and data were …

Strategies To Mitigate Information Technology Discrepancies In Health Care Organizations, Oluwatosin Tolulope Oluokun

Walden Dissertations and Doctoral Studies

Medication errors increased 64.4% from 2015 to 2018 in the United States due to the use of computerized physician order entry (CPOE) systems and the inability to exchange information among health care facilities. Healthcare information exchange (HIE) and subsequent discrepancies resulted in significant medical errors due to the lack of exchangeable health care information using technology software. The purpose of this qualitative multiple case study was to explore the strategies health care business managers used to manage computerized physician order entry systems within health care facilities to reduce medication errors and increase profitability. The population of the study was 8 …

Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel

Walden Dissertations and Doctoral Studies

Globalization and international business increasingly require the services of skilled expatriates in overseas offices. Over the past 50 years, numerous studies have focused on various factors affecting expatriate adjustment, primarily through quantitative research, reaching no conclusions on what factors in cross-cultural training would guarantee expatriate success. Expatriate failure has high personal and organizational costs. The purpose of this study was to use the qualitative methodology of narrative inquiry to investigate the adjustment, transition, and repatriation experience as a holistic process. Two theoretical constructions, Bandura's social learning theory, applied to the learning process in an international assignment, and social identity theory, …

Strategies To Implement Innovations In Hospitals, Schola Mutumene Kabeya

Walden Dissertations and Doctoral Studies

The Patient Protection and Affordable Care Act, which promoted quality of care, started the transformation of healthcare systems in the United States. The purpose of this qualitative multiple case study was to explore clinical practice innovation strategies used by hospital middle managers to improve quality of care and profitability. Pettigrew's theory was the conceptual framework for this study. Participants were 8 middle managers from 2 high-performing hospitals in the southwestern region of the United States. Data were collected from semistructured interviews, personal notes, and review of the hospital's publicly reported documents and literature. Member checking and methodological triangulation increased the …

Succession Planning And Development Of Nurse Leaders, Christina Martin

Walden Dissertations and Doctoral Studies

Health care organizations can provide comprehensive, formal learning opportunities to develop nurse leaders for advanced leadership roles. The purpose of this doctoral project was to create an evidence-based nursing leadership academy focused on development of advanced leadership skills and competencies to cultivate frontline and midlevel nurse leaders for executive nursing and health care leadership positions. The practice-focused question addressed how an advanced nursing leadership education program would affect the knowledge level and competencies of nurse leader participants. The American Organization of Nurse Executives' (AONE) 5 nurse executive competency domains served as the framework for this project. Data were collected from …

Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus

Walden Dissertations and Doctoral Studies

Members of the healthcare industry have not fully understood organizational climate factors that enhance organizational citizenship behaviors (OCBs). This lack of understanding can result in negative patient outcomes. The purpose of this cross-sectional quantitative study was to examine the relationships between organizational climate factors and OCBs of employees at hospitals via person-organization fit theory. More, specifically, the purpose of this research was to explore (a) the relationships between organizational climate variables (i.e., welfare, autonomy, involvement, effort, training, integration, and supervisory support) and OCBs (n = 218), (b) differences in OCB scores between hospital leaders (n = 72) and followers (n …

Implementation Of Food Safety Regulations In Food Service Establishments, Steve Randolph Mcallister

Walden Dissertations and Doctoral Studies

Food service businesses in the United States have experienced millions of dollars in losses caused by foodborne illness outbreaks, which can lead to bankruptcy and business closures. More than 68% of all foodborne illness outbreaks occur in food service establishments. The purpose of this descriptive case study was to explore the strategies leaders of food service establishments use to implement food safety regulations. Force field analysis was the conceptual framework for this study. The population for the study consisted of 3 leaders of food service establishments located in the southeastern region of the United States. Data were collected using semistructured …