Medicine and Health Sciences Commons^™

Evidence-Based Hospice Care Education For Healthcare Clinicians, Nonie E. Weir

Walden Dissertations and Doctoral Studies

Vulnerable populations with a terminal illness, who reside in a nursing home setting, continue to experience psychological, physical, and emotional effects that lead to end-of- life (EOL) suffering and discomfort. Globally, millions of individuals receive care from a hospice provider. By 2030, this figure will triple due to the increased lifespan of the geriatric population. The literature review has revealed that the practical problem is the lack of hospice care education received by healthcare clinicians. It is, therefore, important to prepare and educate healthcare clinicians about a peaceful death through an individualized plan-of-care (POC) from a holistic approach. The purpose …

Workplace Psychosocial Factors, Perception Of Organizational Support, And Congregate Workers’ Quality Of Life, Claudine Alicia Cousins

Walden Dissertations and Doctoral Studies

Congregate care organizations employ workers across various environments from shelters, group homes, long-term care homes, and correctional facilities. Congregate care workers in the developmental services sector face numerous risks that affect their quality of life due to workplace stress from daily interactions with individuals with intellectual disabilities and organizational demands. Workers’ perception of the support received from their organization may further impact their quality of life. The purpose of this quantitative study, guided by organizational support theory, was to examine the relationship among the independent variables of workplace psychosocial factors (defined as vicarious trauma, compassion fatigue, mental stress, or burnout), …

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 …

Work Engagement, Job Satisfaction, And Nurse Turnover Intention, Yolanda Marie Edwards-Dandridge

Walden Dissertations and Doctoral Studies

In the United States, the high turnover rate of registered nurses and indications of a future shortage of registered nurses is detrimental to healthcare organizations. The purpose of this correlational study was to examine whether, in hospitals, work engagement and job satisfaction predicted registered nurse turnover intention. The theoretical framework was Fishbein and Ajzen's theory of reasoned action. Probability sampling was used to identify 155 participants, all full-time registered nurses with 2 or more years of employment in New York hospitals. Data, obtained from surveys, were analyzed via multiple linear regression. The results revealed that only job satisfaction predicted turnover …

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 …

Strategies Used By Healthcare Supervisors For Employee Retention, Serrita Chaney

Walden Dissertations and Doctoral Studies

Healthcare supervisors who lack effective employee retention strategies could negatively affect patient well-being, employee performance, and organizational functions. The purpose of this single case study was to explore strategies that healthcare supervisors used to improve employee retention in 1 health care organization in southeast Georgia. Vroom expectancy theory was the conceptual framework for the study. Data were collected from semistructured interviews with 5 healthcare supervisors in a medium-sized healthcare organization who had hiring responsibilities and a history of implementing successful strategies to improve employee retention. Data were analyzed using coding and word frequency to discern patterns. Three significant themes emerged …

Strategies To Reduce Employee Turnover In Clinical Logistics, Brenda Marc Simon

Walden Dissertations and Doctoral Studies

Clinical supply chain managers who do not apply effective employee turnover strategies could negatively affect team performance, employee morale, employee well-being, patient outcomes, productivity, profitability, and the sustainability of organizational activities. The purpose of this multiple case study was to explore strategies that supply chain managers used to decrease employee turnover in clinical logistics organizations. The targeted population consisted of 6 clinical logistics supply chain managers working in 6 community hospitals located in Maryland who had experience implementing successful strategies to decrease employee turnover. The servant leadership theory served as the study's framework. Data collection included semistructured interviews and 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 …

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 …

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 …

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 …

Improving Workers' Safety And Health In The Zimbabwean Mining And Quarrying Industry, Bernard Mabika

Walden Dissertations and Doctoral Studies

Lack of effective occupational safety and health (OSH) strategies is a reason that

workplace accidents in the mining and quarrying industry remain high, making the

industry one of the riskiest operations worldwide. The purpose of this multiple case study

was to explore successful strategies mining and quarrying leaders in Zimbabwe used to

improve OSH. The key research question addressed successful strategies leaders in the

mining and quarrying industry use to improve employee occupational safety and health in

Zimbabwe. Six successful business leaders from 3 mining and quarrying mines in

Zimbabwe demonstrated an exception to unsafe practices, particularly through their

exceptional …

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist

Walden Dissertations and Doctoral Studies

Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …

Nursing Leadership And Employee Satisfaction Perception In A Virtual Work Environment, Angelique Duffy

Walden Dissertations and Doctoral Studies

Virtual team leaders in health care must have the right resources available to help them effectively perform their jobs. Better performance from the leader may lead to greater employee satisfaction. The problem addressed by this study was the impact of leadership style on employee satisfaction of virtual nurses. The purpose of this quantitative correlational study was to investigate the relationship between the leadership styles of virtual nursing environment leaders as perceived by virtual employee nurses and the nurses' satisfaction as measured by the Multifactor Leadership Questionnaire-short form. Building on the theoretical foundation of Bass's 1990 work, this study examined the …

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 …

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 …

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer

Walden Dissertations and Doctoral Studies

Experts expect a shortage of more than 900,000 nurses by 2022, according to the United States Bureau of Labor Statistics Employment Projections. Turnover in nursing contributes significantly to the shortage and often results from poor leadership of nurse managers. The purpose of this quantitative study was to investigate how servant leadership behaviors affected the psychological state and behavioral response of staff nurses as reflected by job satisfaction and turnover intention. Specifically, the research question addressed whether servant leadership positively contributes to the psychological states and the behaviors of staff nurses leading to greater job satisfaction. The study design was correlational, …

Collaborative Strategies Used To Reduce Billing Administrative Cost, Stella Fayomi-Olaleye

Walden Dissertations and Doctoral Studies

Billing inefficiencies represent 80% of wasteful healthcare administrative costs that are projected to reach $45 billion by 2018. Potentially, a reduced billing administrative cost is estimated to yield an annual savings of $60 billion that could fund other societal needs such as jobs, wage increases, and education. Through the conceptual framework of iceberg change management model, this single case study explored collaborative strategies 3 healthcare billing managers in Dallas, Texas successfully used to reduce billing administrative costs. Data were collected through semistructured interviews and the review of company documents. Using Yin's procedure of examining, comparing, categorizing, and coding data, the …

The Relationship Between Technology Threat Avoidance And Innovation In Health Care Organizations, Melvin R. Fenner Jr

Walden Dissertations and Doctoral Studies

Most leaders of healthcare delivery organizations have increased their rate of technological innovation, but some still struggle to keep pace with other industries. The problem addressed in this study was that senior leaders in some rural ambulatory healthcare facilities failed to innovate, even with recent healthcare technological innovations, which could lead to increased medical errors and a loss of efficiency. The purpose of the study was to examine if a relationship exists between the avoidance of technology threats by senior leaders in ambulatory healthcare organizations and the innovation propensity of the organization. Technology threat avoidance theory served as the theoretical …

Dimensions Of Nurse-Physician Communication, Rachel Malek Hamdan

Walden Dissertations and Doctoral Studies

Hospital leaders set quality and safety as high priorities in their strategic goals. Improving the quality and safety of patient care requires improving internal processes that have direct implications for patient care. Hospital leaders need to improve health care providers' communication as part of improving quality and safety. The problem addressed in this study was the lack of strategies health care administrators use to guide nurse-physician communication patterns in a university medical center in the Middle East. The purpose of this qualitative case study was to explore communication strategies that health care administrators use to guide nurse-physician communication. Relational coordination …

How Does Organizational Culture Impact Rn Engagement, Veronica Anntionette Ruffin-Ellis

Walden Dissertations and Doctoral Studies

Lack of RN engagement in the acute care setting can result in poor staffing, nursing shortages, increased stress levels for nurses and decreased morale. When nurses are not engaged in their work setting, quality of care suffers. A wide range of literature focuses on the importance of RN engagement; however, few health care organizations have taken the initiative to implement programs that foster RN engagement, demonstrating a gap in practice. This study examined the relationship between the levels of RN engagement and their perceptions of their organizational culture. Kolcaba's humanistic approach to meeting the needs of RN staff was used …

Dentists As Clinician Managers: Leadership Influences On Dental Team Empowerment And Engagement, Scott Hinckley Craven

Walden Dissertations and Doctoral Studies

Leadership training is virtually nonexistent for dental students, and practicing dentists rarely engage in any form of leadership development, relying primarily on mentoring by senior colleagues and on-the-job experiences. Dentists serve in a hybrid role as clinicians and managers to provide quality dental care and establish a profitable business, respectively. This quantitative study investigated the ways in which the emotional intelligence (EI) and leadership styles of 16 dentist clinician managers (DCMs) affected their dental teams. Specifically, the effects of leadership style and EI of DCMs on individual psychological empowerment (PE), team PE, and employee engagement were explored. Team PE effects …

Hospital Outcomes Based On Physician Versus Non-Physician Leadership, Collins Yazenga Mkandawire

Walden Dissertations and Doctoral Studies

Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the U.S. hospitals. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital's outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer …

The Relationship Between Nurse Manager Leadership Style And The Enculturation Of Shared Governance, Anna Elizabeth Keane

Walden Dissertations and Doctoral Studies

Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers' role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass' theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A …