Medicine and Health Sciences Commons^™

Breaking The Transactional Mindset: A New Path For Healthcare Leadership Built On A Commitment To Human Experience, Kirsten Krull, Jerry Mansfield, Jennifer Gentry, Karen Grimley, Barbara Jacobs, Jason Wolf

Patient Experience Journal

Numerous health care publications have focused on the compelling need to improve patient experience and the associated improvements necessary to address workforce well-being. The COVID-19 pandemic exacerbated and illuminated long-standing problems in health care including workforce shortages, inequity in health care delivery outcomes, care provider burnout, and overall societal structural racism.^1,2 The Beryl Institute’s Nursing Executive Council (NEC) manuscript Rebuilding a Foundation of Trust: A Call to Action in Creating a Safe Environment for Everyone³ focused on actions and behaviours to heal relationships and build trust between care providers and leaders with commitments to safety, empathy, shared decision …

Four Commitments For The Future Of Healthcare: Reflecting On A Decade Of Patient Experience Journal, Jason A. Wolf

Patient Experience Journal

This issue closes the first decade of Patient Experience Journal’s (PXJ) contribution to evidence and innovation, to sharing stories and research, to elevating the conversation and pushing the boundaries of the experience movement. We have never hesitated to nudge at the status quo or to respond with agility to the challenging moments we have faced. We have welcomed diverse voices as contributors, and we have seen an even more diverse readership. In reviewing the pages of PXJ over the last decade, we see a true evolution of the experience movement itself. The words of our contributors have provided a lens …

What Does It Look Like For Mental Healthcare Organizations To Be Healthy Places To Work? An Action Research Study, Stephanie L. Fox

Antioch University Full-Text Dissertations & Theses

Mental healthcare organizations have a reputation for being unhealthy places to work. The irony of this reputation is keenly felt by its workforce who report unsustainable workloads, high levels of stress, and lack of support or engagement from higher-level leadership. As a mental healthcare provider now in a position of leadership, who has worked across all levels of care within the sector, it was of interest to me to explore how a mental health organization can become a healthier and more sustainable place to work. I approached this study with the assumption that if an organization was healthy and intentional …

Navigating The “Perfect Storm”: Leading With A Commitment To Human Experience, Jason A. Wolf Phd

Patient Experience Journal

As was known even prior to the pressures placed on us by the pandemic, what lied just beneath the surface of our work in healthcare was clear. A healthcare workforce feeling overworked and overwhelmed. Communities seeing and feeling the impact of inequities and disparities in care. Patients and care partners working diligently to elevate what matters to them. A tearing at the social fabric that has led to incivility and even mortal violence. And healthcare systems laboring to maintain financial viability in the face of global economic uncertainties. We knew the opportunities then, and we cannot escape them now. This …

Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca

Patient Experience Journal

Healthcare is the ultimate team sport, and this case study explores how to build teamwork across teams. The ability for nursing, environmental services and food and nutrition services to work collaboratively to benefit patients is paramount to a patients experience and outcomes. The case study describes how the work was done to build teams and then improved outcomes in both patient and employee experiences. The learnings are applicable to any team setting not just those described in this case study.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework ( …

Human Experience Is Not A Line Item, Jason A. Wolf

Patient Experience Journal

Our humanity is fundamentally defined in context with others, in our relationships that reinforce or bend who we are, in the interactions through which we wither or grow. It is these interactions that rest squarely at the heart of the healthcare experience. For over a decade, we have defined experience in The Beryl Institute community as the sum of all interactions, shaped by an organization’s culture that influence patient perceptions across the continuum of care. The power of the simple, yet significant nature of these words reinforces the idea that experience happens primarily at the touch point between people. …

A Managerial Ecosystem For Excellence In Hospital Administration, Denish Gangasingh

Dissertations

Major healthcare systems and hospital organizations face a myriad of challenges in today’s business environment, having to provide very complex and more comprehensive medical care with fewer resources. In this study, we investigate determinants of hospital performance in critical dimensions and propose an information infrastructure intended to promote excellence in clinical performance while sustaining a solid financial footing.

Senior executives must be knowledgeable in both business and clinical aspects of hospital administration because their decisions ultimately affect patient care and clinical outcomes. Key performance indicators (KPI) are necessary on both dimensions to inform their decisions. Financial and operational aspects of …

Raytheon Technologies Corporation: An Analysis Of Leadership, Ethics, And Social Responsibility, Jarett Monterio

Journal of Global Awareness

The purpose of this analysis is to examine Raytheon Technologies Corporation (RTC) in the context of its leadership structure, ethical issues and practices, stakeholder relationships, and position within the social responsibility realm. Undertaking an analysis of an aerospace and defense company such as RTC is perhaps timelier than ever. We live in a world of increasing global competition and confrontation. Simultaneously, we are experiencing unprecedented technological development. Combined, this has created a situation where the boundaries of conventional warfare have been redrawn. The questions of what appropriate offensive and defensive tactics are and how governments, and increasingly private sector companies, …

The Four Agreements Analysis Los Cuatro Acuerdos De Don Miguel Ruíz, Dulce Morales

Electronic Theses, Projects, and Dissertations

The Toltecs were an indigenous Mexican culture of great warriors and artists with a very unique wisdom on life and behavior, that lived around 1000 years ago. Their extended knowledge on life and behavior certainly can be of help on developing a great leader in any organization based on the four agreements they practiced to better themselves spiritually, emotionally and physically. Therefore, Don Miguel Ruiz did some research of the Toltecs Wisdom and learn more about these four agreements:

1. Be impeccable with your word.
2. Don’t take anything personally.
3. Don’t make assumptions.
4. Always do your best.

After learning how to apply …

When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores

Dissertations

In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …

Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara

Walden Dissertations and Doctoral Studies

Ethnic diversity in the U.S. nursing workforce had not been well researched. This aspect of nursing is important to the advancement of the profession because ethnic diversity of nursing helps reduce health care disparities. The purpose of this quantitative correlational study was to examine the possible relationship between the perceived ethnicity of nurse leaders and the engagement of bedside nurses. Culture of care theory was the theoretical foundation for this study. The Utrecht Work Engagement Scale with additional demographic questions was used to survey 53 bedside nurses with 2 or more years of experience. Simple regression was used to analyze …

Competencies For Successful Middle Managers In Healthcare And Medical Education, Ahmed Al Ansari

Antioch University Full-Text Dissertations & Theses

The Kingdom of Saudi Arabia (KSA) and the Kingdom of Bahrain (KB) are currently in the process of the rapid transformation of health care to a self-sustained autonomous system. Middle managers play a pivotal role in achieving this goal. The aim of this study is to develop a feasible, reliable, and valid scale for measuring the leadership and managerial competencies of MM in KSA and KB. Zhou’s (2019) conceptual framework using a mixed-method approach was followed. After procuring ethical clearance from concerned authorities and informed consent from all the participants (n = 27), semi-structured interviews were conducted across three groups: …

Integrating Interpersonal Neurobiology In Healthcare Leadership And Organizations, Lynn Redenbach

Antioch University Full-Text Dissertations & Theses

Interpersonal Neurobiology (IPNB) is an interdisciplinary, science-based field that seeks to understand human reality including the nature of mind, brain, and relationships. IPNB has been used extensively by mental health practitioners as well as child development and parenting experts. While practitioners and scholars have described ways that IPNB can be used in leadership and organizations, there has been no systematic inquiry into the practical and phenomenological experience of this application. IPNB offers an alternative to dominant models of care and leading in healthcare settings and fields, which are characterized by disconnection, objectification, and separation. It offers a relationally centered approach …

Lessons Learned From Bp: Deepwater Horizon And The Transition To Renewables, Daniel Valle

Journal of Global Awareness

This paper analyzes the gradual transition of British Petroleum (BP), one of the world's largest oil and gas companies, into a renewable energy company focused on sustainability and the reduction of carbon emissions. BP's leadership and ethical practices are compared before and after the 2010 Deepwater Horizon disaster. The purpose of the comparison and the broader analysis of the transition is to identify how effective leadership can be used to transform a company with a suspect social responsibility record into a leader among its peers. Lessons learned from the disaster, and the subsequent transition conclude the research.

Attributes And Characteristics Of The Physician-Physician Assistant Organizational Leader Relationship, Victoria S. Louwagie

Graduate Dissertations and Theses

Purpose: The aim of this study was to evaluate and better understand the attributes and characteristics of the influential physician, the dual-roled physician assistant (PA)leader and how this relationship impacts the PA leader and the PA leader-physician relationship. These dual-role PA leaders may possess additional formal job titles and duties while also having direct reports.

Method: We surveyed PA leaders at a large academic medical center and its associated health system. The survey instrument evaluates perceptions, attitudes and characteristics of the PA leader, influential physician, and their relationship.

Results: There were 34/56 PA organizational leaders that responded to the survey …

Preventable Error Reduction Leadership Strategies Of Nurse Managers In A Hospital Setting, Sedrick Diego Bedolla

Walden Dissertations and Doctoral Studies

AbstractPreventable medical errors in the healthcare industry account for hundreds of thousands of patient deaths annually. Nurse managers strive to develop strategies to reduce incidences of preventable medical error and increase patient safety in their organization to improve performance and reduce harm in the healthcare industry. Grounded in the complex adaptive systems theory, the purpose of this qualitative single case study was to explore strategies nurse managers use to reduce the rate of preventable medical errors among employees. The participants comprised 6 nurse managers who successfully used strategies to lower the rate of preventable errors in a healthcare facility in …

Empowerment, Personality, And Leader-Member Exchange Quality In Physicians, Tony S. Reed

Walden Dissertations and Doctoral Studies

Nearly 100,000 people suffer injury or death each year due to errors in the United States healthcare system. Researchers have identified that empowerment by physicians can address this significant social issue. Despite this knowledge, qualifications to empowering behaviors in physicians have not been identified. A quantitative nonexperimental correlation approach was used to determine the role that personality type and high-quality leader-member exchange may play in the physician’s ability to create empowerment at academic medical centers in the United States. The theoretical framework of empowering leadership, Jung’s psychological types, and leader-member exchange quality informed the research design and contributed to the …

Improving Clinical Communication And Collaboration Through Technology, Michelle Machon

Doctor of Nursing Practice (DNP) Projects

Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems.

Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health …

Effects Of Transformational Leadership On Direct Home Healthcare Employee Turnover, Lisa K. Johnson

Walden Dissertations and Doctoral Studies

Ineffective leadership and excessive direct home healthcare workers’ intent to resign may decrease home healthcare worker satisfaction, increase workplace accidents, and hinder the quality of patient home healthcare. Home healthcare leaders have a problem of retaining direct home healthcare workers and can benefit from comprehending the factors that enhance leadership and mitigate the turnover of home healthcare workers. Grounded in transformational leadership theory, the purpose of this quantitative correlational study was to examine the relationship between the perception of transformational leadership behaviors and direct care intent to resign. The population consisted of direct home healthcare workers who reported to frontline …

The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik

Walden Dissertations and Doctoral Studies

Research studies have shown that organizational leadership and support affect organizational outcomes in many sectors, including healthcare. However, less is known about how organizational leadership influences the quality of patient care by physicians. This study was guided by the perceived organizational support theory and leader-member exchange theory that provide general understanding of how supportive leadership influences staff wellbeing and productivity. Ninety-five resident physicians residing in Lebanon participated in this cross-sectional study and completed an online survey, which consisted of demographics and five tools, namely, the Leader-Member Exchange 7, Perceived Organization Support 8, Maslach Burnout Inventory 7, Utrecht Work Engagement 9, …

Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson

Walden Dissertations and Doctoral Studies

In response to healthcare payment policy reforms, billions of dollars in healthcare provider charges are challenged annually. Following the implementation of the Virginia workers’ compensation medical fee legislation, healthcare organizations experienced declining worker compensation medical fee schedule reimbursements and lack of profitability. Grounded in the adaptive cycle model, the purpose of this qualitative single case study was to explore strategies 2 urgent care center (UCC) leaders in Virginia used to increase profits after implementing the Virginia workers’ compensation medical fee legislation. Data were collected via in-depth interviews and a review of company documents. Thematic analysis was used to analyze data. …

Physician Assistant Burnout And Fulfillment Related To Career Development And Physician Relationship, Kari Sue Bernard

Walden Dissertations and Doctoral Studies

Physician workforce shortages are driving increased clinical and administrative use of non-physician healthcare providers. As a result, physician assistants (PAs) may experience role expansion in a positive or negative manner. The purpose of this study was to determine if aspects of PA career development related to role expansion interacted with the quality of the collaborative physician (CP) relationship to predict PA well-being. The job demands-resources (JD-R) model was used as the theoretical foundation and the National Academy of Medicine’s conceptual model of clinician well-being was used as the conceptual framework. Research questions addressed whether PA experience level predicted well-being, and …

Healthcare Organizational Design Strategies To Improve Performance, Katherine Madonna Chubbs

Walden Dissertations and Doctoral Studies

Business leaders are exploring ways to improve organizational performance through organizational design, including reviewing the structures of their organization. Grounded in McKinsey’s 7S framework, the purpose of this qualitative single case study was to explore organizational design strategies healthcare leaders used to improve organization performance. Participants were 6 leaders within a healthcare organization in Alberta, Canada, who successfully developed and implemented organizational design strategies to improve organizational performance. The data collection techniques included a review of internal and external documents, a reflective journal, and semistructured interviews. I used methodological triangulation and thematic analysis to complete the data analysis. The data …

The Experience Of Children's Mental Health Leaders During Times Of Constraint: A Narrative Study, Jody Levison-Johnson

Antioch University Full-Text Dissertations & Theses

Across the United States, each state has a public mental health system that is designed to support children and youth with emotional and behavioral challenges. This is critically important as recent estimates show that one in six children in the United States has a diagnosed mental health condition (Whitney & Peterson, 2019). The design and structure of these systems vary by state, but consistent across them is the presence of a state-designated leader who is faced with an array of constraining factors that influence their behavior and shape the resulting system. This study describes the experience of leaders in children’s …

Understanding The Context And Social Processes That Shape Person- And Family-Centered Culture In Long-Term Care: The Pivotal Role Of Personal Support Workers, Ellen Helena Melis

Antioch University Full-Text Dissertations & Theses

This single, exemplar case study explored the context and social processes that shape person-and family-centered culture in a long-term care (LTC) home, using grounded theory and situational analysis for the data collection and analysis. Findings revealed one core dimension: needing to be heard, valued, and understood, and five key roles: personal support workers (PSWs), executive director (ED), senior leadership, nurse managers, and residents and families, which informed five dimensions, each focused on enhancing care for residents: (a) attending to residents’ daily care needs (PSWs), (b) advocating strategically (ED), (c) translating vision into programs and policies (senior leadership), (d) ensuring quality …

Strengthening Safety Culture By Leveraging The Daily Management System, Suneela Nayak, Mark Parker, Erin Graydon Baker, Amy Sparks, Ruth Hanselman, Stephen Tyzik, Sydney Green

Operational Transformation

STRENGTHENING SAFETY CULTURE BY LEVERAGING THE DAILY MANAGEMENT SYSTEM

There is abundant evidence that links a strong culture of safety with improved patient and staff experience. However, there has been no clear avenue identified as to how to achieve this metric.

A team in a large academic tertiary teaching hospital set about leveraging their daily managing system (DMS) to attain improvement in their institution’s safety. The goals of this quality improvement project were to use DMS to identify and report safety concerns and increase frontline team knowledge and comfort with reporting safety concerns during Gemba walks.

A root cause analysis …

Doing From Being: Creating Organizational Integrity Through Mindful Self-Leadership, Adam Stonebraker

Mindfulness Studies Theses

Mindfulness in the workplace is a subject that has seen significant growth in recent years. Mindfulness, which is rooted in ancient contemplative practice, has gained much traction among Western audiences over the last few decades. The application of Mindfulness practices is prevalent now in workplaces, where its efficacy has been well-documented, and impact has included the reduction of employee stress, increased productivity, and enhancement of one’s well-being.

The principles of mindfulness can be applied across disparate workplace settings and in nearly any situation to help bolster employees’ presence and focus in the day-to-day and retain them in the place of …

Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward

Walden Dissertations and Doctoral Studies

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …

Surgical Perioperative Leadership: The Association Between Leadership Style And Team Job Satisfaction, Corey Louise Jamison

Walden Dissertations and Doctoral Studies

Abstract

The perioperative operating room (OR) is a highly complex, fast-paced environment where countless transactions must be executed with efficiency, speed, and accuracy, and where mistakes of any kind could lead to adverse patient outcome, injury, or death. The surgeon, as leader of the procedure and the OR team, sets the overall climate of the OR and determines how willing (or unwilling) team members are to speak up about potential errors or unsafe patient conditions. This exploration of the relationship between perioperative surgeon leadership style and OR team member job satisfaction fills a gap unaddressed in the literature using items …

Transformational Leadership In Club Sports: An Instrument For Evaluation And Assessment, Nathan Shelby Hutchens

Graduate Theses and Dissertations

Campus Recreation and its programs can be used as a way to combat the national trends of decreasing enrollment and retention (Weaver, Forte, & McFadden, 2017; Kampf & Teske, 2013). In fact, 62% of students indicate that Campus Recreation programs are a factor when choosing an institution and 67% indicate that recreation programs were a factor when deciding to stay at a particular institution (Forrester, 2014). As a program within Campus Recreation, Club Sports specifically is perceived to have the greatest health and wellbeing benefits out of all Campus Recreation programming (Lower, Turner, & Petersen, 2013). Due to the voluntary …